Study of Philadelphia Like Acute Lymphoblastic Leukemia in Adult Patients Using CRLF2 Expression and JAK2 r683 mutation
Mokhtar Ahmed, A., Ibrahem Ahmad, E., Gawish, H., Abd El Rheem El Naggar, A., Gaber, N., Awad, E. (2025). Study of Philadelphia Like Acute Lymphoblastic Leukemia in Adult Patients Using CRLF2 Expression and JAK2 r683 mutation. EKB Journal Management System, 31(8), 4169-4178. doi: 10.21608/zumj.2025.387268.3964
Ahmed Mokhtar Ahmed; Ebtesam Ibrahem Ahmad; Heba Gawish; Ahmad Abd El Rheem El Naggar; Nadia Gaber; Eman Mohamed Awad. "Study of Philadelphia Like Acute Lymphoblastic Leukemia in Adult Patients Using CRLF2 Expression and JAK2 r683 mutation". EKB Journal Management System, 31, 8, 2025, 4169-4178. doi: 10.21608/zumj.2025.387268.3964
Mokhtar Ahmed, A., Ibrahem Ahmad, E., Gawish, H., Abd El Rheem El Naggar, A., Gaber, N., Awad, E. (2025). 'Study of Philadelphia Like Acute Lymphoblastic Leukemia in Adult Patients Using CRLF2 Expression and JAK2 r683 mutation', EKB Journal Management System, 31(8), pp. 4169-4178. doi: 10.21608/zumj.2025.387268.3964
Mokhtar Ahmed, A., Ibrahem Ahmad, E., Gawish, H., Abd El Rheem El Naggar, A., Gaber, N., Awad, E. Study of Philadelphia Like Acute Lymphoblastic Leukemia in Adult Patients Using CRLF2 Expression and JAK2 r683 mutation. EKB Journal Management System, 2025; 31(8): 4169-4178. doi: 10.21608/zumj.2025.387268.3964

Study of Philadelphia Like Acute Lymphoblastic Leukemia in Adult Patients Using CRLF2 Expression and JAK2 r683 mutation

Zagazig University Medical Journal
Volume 31, Issue 8, August 2025, Page 4169-4178  XML PDF (1.09 MB)
Document Type: Original Article
DOI: 10.21608/zumj.2025.387268.3964
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Authors
Ahmed Mokhtar Ahmed email orcid 1; Ebtesam Ibrahem Ahmad2; Heba Gawish3; Ahmad Abd El Rheem El Naggar4; Nadia Gaber5; Eman Mohamed Awad6
1clinical pathology faculty of Medicine Zagazig University
2profossor of clinical pathology, faculty of Medicine Zagazig University
3clinical pathology department, faculty of Medicine, Zagazig University
4Oncology Department, Faculty of Medicine- Zagazig University. Zagazig, Egypt.
5Department of clinical Pathology zagazig University
6Clinical Pathology Department, Faculty of Medicine - Zagazig University, Egypt
Abstract
Background: A Philadelphia-like acute lymphoblastic leukemia (Ph-like ALL) is a high-risk B-cell ALL subtype that is identified by a gene expression profile similar to Philadelphia chromosome-positive ALL, and lacking the BCR-ABL1 fusion. In this study, we analyzed molecular and clinical data to examine the coexistence and prognostic implications of CRLF2 overexpression and JAK2 r683 mutations in adult Ph-like ALL; we evaluate the potential utility of these biomarkers for risk stratification. Methods: In this study, we enrolled newly diagnosed fifty adult Ph-like ALL patients. Fluorescence In Situ Hybridization (FISH) was employed to evaluate CRLF2 expression, and Sanger sequencing was employed to identify JAK2 mutations. Results: The mean age of the 50 patients was 38.86 years, with a range of 18 to 64 years. Typically, 70% of the patients were male. Concerning CRLF2, only nine patients (18%) had expressed CRLF2 and all showed wild type JAK2 r6839 expression. CRLF2 demonstrated a significant connection with cytogenetic risk (p < 0.003). Moreover, CRLF2 manifested significant connection with relapse-free survival (RFS) and overall survival (OS), with positive CRLF2 correlating with reduced RFS and diminished OS, Positive CRLF2 significantly increase hazard of mortality by 7.54 folds while it significantly increases hazard of relapse by 6 folds.

Conclusion: CRLF2 has a prognostic role in adult Ph-like ALL, it may be used as a marker of bad prognosis together with other parameters to classify patients who need more aggressive therapy.
Keywords
Keywords: Philadelphia-like acute lymphoblastic leukemia; cytokine receptor-like factor 2 (CRLF2); JAK2 mutations
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